Technique, safety, and feasibility of EUS-guided radiofrequency ablation in unresectable pancreatic cancer
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Background and aims
Radiofrequency ablation (RFA) is a well-recognized local ablative technique applied in the treatment of different solid tumors. Intraoperative RFA has been used for non-metastatic unresectable pancreatic ductal adenocarcinoma (PDAC), showing increased overall survival in retrospective studies. A novel RFA probe has recently been developed, allowing RFA under endoscopic ultrasound (EUS) guidance. Aim of the present study was to assess the feasibility and safety of EUS-guided RFA for unresectable PDACs.
Patients with unresectable non-metastatic PDAC were included in the study following neoadjuvant chemotherapy. EUS-guided RFA was performed using a novel monopolar 18-gauge electrode with a sharp conical 1 cm tip for energy delivery. Pre- and post-procedural clinical and radiological data were prospectively collected.
Ten consecutive patients with unresectable PDAC were enrolled. The procedure was successful in all cases and no major adverse events were observed. A delineated hypodense ablated area within the tumor was observed at the 30-day CT scan in all cases.
EUS-guided RFA is a feasible and safe minimally invasive procedure for patients with unresectable PDAC. Further studies are warranted to demonstrate the impact of EUS-guided RFA on disease progression and overall survival.
KeywordsPancreatic ductal adenocarcinoma Unresectable pancreatic cancer Radiofrequency ablation Endoscopic ultrasound
Pancreatic ductal adenocarcinoma
Superior mesenteric artery
Superior mesenteric vein
Magnetic resonance imaging
We kindly thank Dr. Marzio Frazzoni for the unevaluable contribution in paper revision.
Compliance with ethical standards
Dr. Filippo Scopelliti, Dr. Antonio Pea, Dr. Rita Conigliaro, Dr. Giovanni Butturini, Dr. Isabella Frigerio MD, Dr. Paolo Regi, Dr. Alessandro Giardino, Dr. Helga Bertani, Dr. Marina Paini, Prof. Paolo Pederzoli, and Dr. Roberto Girelli have no conflicts of interest or financial ties to disclose.
Supplementary material 1 (MOV 74194 KB)
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